妊娠期糖尿病母亲新生儿血清蛋白质、血脂、免疫功能的变化及临床意义  

The clinical significance of serum protein,blood lipid and immune function in neonatal with maternal gestational diabetes mellitus

作　　者：袁二伟[1] 朱雷 郭华贤[1] 许津莉[1] 曹希 YUAN Er-wei;ZHU Lei;GUO Hua-xian;XU Jin-li;CAO Xi(Department of Neonatology,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院附属第一医院新生儿科,河北张家口075000

出　　处：《广东医学》2023年第3期288-292,共5页Guangdong Medical Journal

基　　金：河北省医学科学研究课题计划(20211817)。

摘　　要：目的探讨妊娠期糖尿病(GDM)母亲新生儿血清蛋白质、血脂、免疫功能的变化及临床意义。方法选择2020年7月至2021年12月收治的108例诊断为GDM母亲新生儿作为研究对象,另选择同期80例正常母亲新生儿作为对照组。所有新生儿均于出生后24 h时采集空腹外周静脉血5 mL,检测两组新生儿的血清蛋白质[总蛋白(TP)、白蛋白(ALB)、球蛋白(GLB)、前白蛋白(PA)],血脂水平{脂蛋白a[Lp(a)]、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)}和血清免疫球蛋白(Ig)G、IgM、IgA、补体C3、补体C4水平,以及外周血自然杀伤(NK)细胞比例和T淋巴细胞亚群(包括CD3^(+)、CD4^(+)、CD8^(+)T细胞比例),并计算CD4^(+)T细胞与CD8^(+)T细胞比值(CD4^(+)/CD8^(+))。结果观察组新生儿血清TP、ALB、GLB和PA水平均显著低于对照组新生儿(P<0.05)。观察组新生儿血清Lp(a)、TG、TC和LDL-C水平均显著高于对照组新生儿(P<0.05),血清HDL-C浓度显著低于对照组新生儿(P<0.05)。观察组新生儿血清IgG、补体C3水平均显著低于对照组新生儿(P<0.05),两组新生儿血清IgM、IgA和补体C4水平比较差异无统计学意义(P>0.05)。观察组新生儿外周血NK细胞及CD3^(+)、CD4^(+)T细胞比例和CD4^(+)/CD8^(+)均显著低于对照组新生儿(P<0.05),外周血CD8^(+)T细胞比例则显著高于对照组新生儿(P<0.05)。结论GDM可导致新生儿血清蛋白质水平降低,血脂代谢紊乱,体液免疫与细胞免疫功能下降,从而不利于其生长发育。Objective To investigate the changes and clinical significance of serum protein,blood lipid and immune function in newborns with maternal gestational diabetes mellitus(GDM).Methods From July 2020 to December 2021,108 newborn,whose mothers diagnosed with GDM,admitted to the department of neonatology of our hospital were selected;and 80 normal newborn delivered in our hospital during the same period were selected as the control group.Fasting peripheral venous blood(5 mL)was collected from all neonates 24 h after birth,and serum proteins,including total protein(TP),albumin(ALB),globulin(GLB),and prealbumin(PA),were detected in both groups.Blood lipid levels,including lipoprotein A(LpA),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C);serum immunoglobulin G(IgG),IgM,IgA,complement C3 and complement C4 levels were assessed.The proportion of peripheral blood natural killer(NK)cells and T lymphocyte subsets(including CD3^(+),CD4^(+)and CD8^(+)T cells),and the ratio of CD4^(+)T cells to CD8^(+)T cells(CD4^(+)/CD8^(+))were calculated.Results The serum levels of TP,ALB,GLB and PA in the observation group were significantly lower than those in the control group(P<0.05).Serum LpA,TG,TC and LDL-C levels in observation group were significantly higher than those in control group(P<0.05),and serum HDL-C concentration was significantly lower than that in control group(P<0.05).The serum IgG and complement C3 levels in the observation group were significantly lower than those in the control group(P<0.05),but there was no significant difference in the serum IgM,IgA or complement C4 levels between the two groups(P>0.05).The proportion of NK cells,CD3^(+),CD4^(+)T cells and CD4^(+)/CD8^(+)in observation group were significantly lower than those in control group(P<0.05),while the proportion of CD8^(+)T cells in observation group was significantly higher than that in control group(P<0.05).Conclusion GDM can lead to the decrease of serum protein level,the disord

关 键 词：妊娠期糖尿病 新生儿 蛋白质 血脂 体液免疫 细胞免疫 

分 类 号：R714.256[医药卫生—妇产科学] R714.5[医药卫生—临床医学]